Ethics and Professional Issues

Question 1

Child Abuse Reporting

Answer 1

Although the specific laws vary from jurisdiction to jurisdiction, all jurisdictions require psychologists to report known or suspected cases of child abuse to the appropriate authorities.

Question 2

Client Access To Records

Answer 2

Client access to records is determined by law but, in general, the psychologist is the owner of the physical record while the client has the right to inspect the contents of the record.

Question 3

Client Testimonials

Answer 3

Standard 5.05 states that “psychologists do not solicit testimonials from current therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence.”

Question 4

Client Welfare

Answer 4

Standard 3.04 addresses client welfare in a general way and states that psychologists “take reasonable steps” to avoid and minimize harm to clients, students, research participants, and others with whom they work.

Question 5

Clients Receiving Services From Another Professional

Answer 5

Standard 10.04 states that “in deciding whether to offer or provide services to those already receiving mental health services elsewhere, psychologists carefully consider the treatment issues and the potential client’s/patient’s welfare. Psychologists discuss these issues with the client/patient … and proceed with caution.”

Question 6

Collection Agencies

Answer 6

Standard 6.04 states that “if the recipient of services does not pay for services as agreed, and if psychologists intend to use collection agencies or legal measures to collect the fees, psychologists first inform the person that such measures will be taken and provide that person an opportunity to make prompt payment.”

Question 7

Competence

Answer 7

Standard 2.01 requires psychologists to “provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or professional experience.”

Question 8

Competence To Stand Trial

Answer 8

Laws related to competence to stand trial were derived from the standard set forth in Dusky v. United States (1960), which defines a defendant as incompetent if, as the result of mental defect or illness, the defendant lacks “sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding, and … a rational as well as a factual understanding of the proceedings against him.”

Question 9

Complainants And Respondents

Answer 9

Standard 1.08 states that “psychologists do not deny persons employment, advancement, admissions to academic or other programs, tenure, or promotion, based solely upon their having made or their being the subject of an ethics complaint. This does not preclude taking action based upon the outcome of such proceedings or considering other appropriate information.”

Question 10

Confidentiality

Answer 10

Confidentiality refers to the obligation of psychologists to protect clients from unauthorized disclosure of information revealed in the context of the professional relationship. Confidentiality is an ethical principle and, in some situations, a legal requirement.

Question 11

Consultation

Answer 11

Standard 4.06 states that “when consulting with colleagues, (1) psychologists do not disclose confidential information that reasonably could lead to the identification of a client/patient, research participant, or other person or organization with whom they have a confidential relationship unless they have obtained the prior consent of the person or organization or the disclosure cannot be avoided, and (2) they disclose information only to the extent necessary to achieve the purposes of the consultation.”

Question 12

Cost Analysis

Answer 12

Cost analysis refers to techniques that are used to assess the costs of an intervention in order to facilitate decision-making about the intervention. Methods of cost analysis include cost-benefit, cost-effectiveness, cost-utility, cost-feasibility, cost-minimization analysis, and cost-offset analysis.

Question 13

Deception In Research

Answer 13

Standard 8.07 states that deception is acceptable only when the following conditions are met: (a) The use of deception is justified by the “study’s significant prospective scientific, educational, or applied value and … effective nondeceptive alternative procedures are not feasible”; (b) prospective participants are not deceived about conditions that can be “reasonably expected to cause physical pain or severe emotional distress”; and (c) participants will be debriefed “preferably at the conclusion of their participation, but no later than at the conclusion of the data collection.”

Question 14

Education And Supervision

Answer 14

Standards 7.01 through 7.06 address education and supervision and require psychologists to act competently and responsibly when teaching, supervising, and designing education and training programs and to avoid misrepresenting themselves or their work when performing these functions.

Question 15

EPPP

Answer 15

The EPPP (Examination for Professional Practice in Psychology) is a requirement for licensure in the United States and Canada. It is prepared by the Association of State and Provincial Psychology Boards (ASPPB) and is designed to assist the boards “in their evaluation of the qualifications of applicants for licensure and certification” by assessing “the knowledge that the most recent practice analysis has determined as foundational to the competent practice of psychology” (ASPPB, 2010).

Question 16

Ethical Violations By Colleagues

Answer 16

Standard 1.04 encourages psychologists to handle ethical violations informally by discussing the matter with the offender when an “informal resolution appears appropriate”; while Standard 1.05 states that psychologists make a formal report to the Ethics Committee, state licensing board, or other appropriate authority when the problem involves “substantial harm” and is not appropriate for an informal resolution or has not been resolved satisfactorily by an attempt at an informal resolution. These Standards also require that, before psychologists take any action, they must consider the issue of client confidentiality.

Question 17

Fact Versus Expert Witness

Answer 17

A fact witness is a person “who testifies as to what he/she has seen, heard, or otherwise observed regarding a circumstance, event or occurrence as it actually took place…. Fact witnesses are generally not allowed to offer an opinion, address issues that they do not have personal knowledge of or respond to hypothetical situations” (APA, 1998, p. 7). An expert witness is a person “who by reason of education or specialized experience possesses superior knowledge respecting a subject about which persons having no particular training are incapable of forming an accurate opinion or deducing correct conclusions” (Nolan & Nolan-Haley, 1990, p. 578). A person who has been qualified as an expert witness by the court is allowed to offer opinions and provide testimony based on hypothetical scenarios.

Question 18

General Guidelines for Providers of Psychological Services

Answer 18

The General Guidelines were adopted “as a means of self-regulation in the public interest,” and its provisions are general and aspirational. It delineates basic guiding principles for all providers of psychological services (except for those who teach psychology, conduct research, or write and edit scientific manuscripts), and its goal is to “improve the quality, effectiveness, and accessibility of psychological services.”

Question 19

Guidelines For Child Custody Evaluations In Family Law Proceedings

Answer 19

The goal of the Guidelines for Child Custody Evaluations is “to promote proficiency” in the conduct of child custody evaluations, and it provides aspirational guidelines that are intended to “facilitate the continued systematic development of the profession and help facilitate a high level of practice by psychologists.” It states that determining the “psychological best interests” of the child is the primary purpose of a child custody evaluation and that the child’s welfare is always of paramount importance.

Question 20

Guidelines For Providers Of Psychological Services To Ethnic, Linguistic, And Culturally Diverse Populations

Answer 20

The Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations presents aspirational principles and guidelines for psychologists working with members of ethnic, linguistic, and culturally diverse populations. It emphasizes the importance of competence and presents recommendations for incorporating cultural issues and knowledge into practice.

Question 21

In-Person Solicitation

Answer 21

Standard 5.06 states that “psychologists do not engage, directly or through agents, in uninvited in-person solicitation of business from actual or potential therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence.” It also identifies two exceptions to this prohibition - i.e., making “collateral contacts for the purpose of benefiting an already engaged therapy client/patient … [and] providing disaster or community outreach services.”

Question 22

Informed Consent And Assent

Answer 22

Standard 3.10 states that “when psychologists conduct research or provide assessment, therapy, counseling, or consulting services in person or via electronic transmission or other forms of communication, they obtain the informed consent of the individual or individuals using language that is reasonably understandable to that person or persons.” It also states that “for persons who are legally incapable of giving informed consent, psychologists nevertheless (1) provide an appropriate explanation, (2) seek the individual’s assent, (3) consider such persons’ preferences and best interests, and (4) obtain appropriate permission from a legally authorized person.”

Question 23

Informed Consent For Research

Answer 23

Standard 8.02 states: “(a) When obtaining informed consent …, psychologists inform participants about (1) the purpose of the research, expected duration, and procedures; (2) their right to decline to participate and to withdraw from the research once participation has begun; (3) the foreseeable consequences of declining or withdrawing; (4) reasonably foreseeable factors that may be expected to influence their willingness to participate such as potential risks, discomfort, or adverse effects; (5) any prospective research benefits; (6) limits of confidentiality; (7) incentives for participation; and (8) whom to contact for questions about the research and research participants’ rights.”

Question 24

Informed Consent For Therapy

Answer 24

Standard 10.01 states: “(a) When obtaining informed consent to therapy …, psychologists inform clients/patients as early as is feasible in the therapeutic relationship about the nature and anticipated course of therapy, fees, involvement of third parties, and limits of confidentiality and provide sufficient opportunity for the client/patient to ask questions and receive answers.”

Question 25

Insanity

Answer 25

Insanity is a legal concept and most definitions reflect the rule set forth by the American Law Institute, which states that a person is not guilty by reason of insanity when, because of a mental disease or defect, “that person lacks substantial capacity to appreciate the wrongfulness of the act or lacks substantial capacity to behave according to the requirements of the law” (Gutheil, 1995, p. 2764).

Question 26

Interruption and Termination of Therapy

Answer 26

Standard 10.10 requires psychologists to “terminate therapy when it becomes reasonably clear that the client/patient no longer needs the service, is not likely to benefit, or is being harmed by continued service” and, when doing so, to “provide pretermination counseling and suggest alternative service providers as appropriate.” An exception to this general rule is provided in Standard 10.10(b), which states that pretermination counseling or referral is not necessary when a psychologist is terminating therapy with a client because the client or a person the client has a relationship with poses a threat to the psychologist.

Question 27

Malpractice

Answer 27

For a client or other person to bring a claim of malpractice against a psychologist, four conditions must be met: (1) The psychologist must have had a professional relationship with the person that established a legal duty of care. (2) There must be a demonstrable standard of care that the psychologist has breached. (3) The person suffered harm or injury. (4) The psychologist’s breach of duty within the context of the standard of care was the proximate cause of the person’s harm or injury

Question 28

Multiple Relationships

Answer 28

Standard 3.05 states that “a psychologist refrains from entering into a multiple relationship if it could reasonably be expected to impair the psychologist’s objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.”

Question 29

Obsolete Tests

Answer 29

Standard 9.08 states that psychologists “do not base their assessment or intervention decisions or recommendations on data or test results that are outdated for the current purpose … [and] do not base such decisions or recommendations on tests and measures that are obsolete and not useful for the current purpose.”

Question 30

Personal Problems

Answer 30

Standard 2.06 states: “(a) Psychologists refrain from initiating an activity when they know or should know that there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner … [and] (b) When psychologists become aware of personal problems that may interfere with their performing work-related duties adequately, they take appropriate measures, such as obtaining professional consultation or assistance, and determine whether they should limit, suspend, or terminate their work-related duties.”

Question 31

Privilege And Holder Of The Privilege

Answer 31

Privilege is a legal concept that protects a client’s confidentiality in the context of legal proceedings. Most jurisdictions have laws that establish privilege for communications between licensed mental health practitioners and their clients. The client is ordinarily the “holder of the privilege,” but a psychologist can claim the privilege on behalf of a client, and there are legally defined exceptions to privilege.

Question 32

Pro Bono Services

Answer 32

Although the term pro bono is not used in the Ethics Code, General Principle B (Fidelity and Responsibility) states that “psychologists strive to contribute a portion of their professional time for little or no compensation or personal advantage.” Because pro bono services are addressed in the Ethics Code’s aspirational General Principles rather than in its mandatory Ethical Standards, this means that pro bono services are recommended by the Code but are not required.

Question 33

Publication Credit

Answer 33

Standard 8.12 states: “(a) Psychologists take responsibility and credit, including authorship credit, only for work they have actually performed or to which they have substantially contributed … [and] (b) Principal authorship and other publication credits accurately reflect the relative scientific or professional contributions of the individuals involved, regardless of their relative status.”

Question 34

Referral Fees

Answer 34

Standard 6.07 states: “When psychologists pay, receive payment from, or divide fees with another professional, other than in an employer-employee relationship, the payment to each is based on the services provided (clinical, consultative, administrative, or other) and is not based on the referral itself.”

Question 35

Responding to a Subpoena

Answer 35

(1) The first step is to determine if the subpoena is a legally valid demand. (2) If the subpoena is valid, a formal response is required, but the psychologist should first contact the client to discuss the implications of providing the requested information. (3) If the client consents to disclosure and there is no valid reason for withholding the information, the psychologist should provide the requested information. If the client does not consent, the psychologist or his/her attorney can attempt to negotiate with the party who issued the subpoena. (4) If the client does not consent and the requesting party continues to demand that the information be provided, the psychologist can seek guidance from the court informally through a letter or have his/her attorney file a motion to quash the subpoena or a motion for a protective order

Question 36

Sexual Harassment

Answer 36

Standard 3.02 prohibits psychologists from engaging in sexual harassment, which it defines as “sexual solicitation, physical advances, or verbal or nonverbal conduct that is sexual in nature, that occurs in connection with the psychologist’s activities or roles as a psychologist, and that either (1) is unwelcome, is offensive, or creates a hostile workplace or educational environment, and the psychologist knows or is told this or (2) is sufficiently severe or intense to be abusive to a reasonable person in the context.”

Question 37

Sexual Intimacies With Clients And Former Clients

Answer 37

Standard 10.05 explicitly prohibits psychologists from having sexual relationships with current clients, while Standard 10.08 forbids a psychologist from having a sexual relationship with a former client for at least two years after cessation of therapy. The latter Standard also states that, even after the two-year limit has passed, a relationship may be acceptable only in the “most unusual circumstances.” Standard 10.07 prohibits psychologists from providing therapy to people with whom they have had sexual relationships in the past.

Question 38

Sexual Misconduct By Psychotherapists

Answer 38

Research on sexual misconduct has found that male therapists engage in sexual and other dual relationships with clients much more often than female therapists. The data also show that male therapists who engage in sexual misconduct are usually older than the female clients they become involved with, with the average therapist being between 42 and 44 and the client being between 30 and 33. No consistent relationship has been found between risk for sexual misconduct and theoretical orientation, professional experience, or education (Pope et al., 1993).

Question 39

Sexual Relations With Students And Supervisees

Answer 39

Standard 7.07 states that “psychologists do not engage in sexual relationships with students or supervisees who are in their department, agency, or training center or over whom psychologists have or are likely to have evaluative authority.”

Question 40

Sliding Fee Scale

Answer 40

A sliding fee scale is not explicitly addressed by the Ethics Code but is generally considered acceptable as long as the scale is fair and serves the best interests of the client.

Question 41

Specialty Guidelines for Forensic Psychology

Answer 41

The goals of the Specialty Guidelines for Forensic Psychology “are to improve the quality of forensic psychological services; enhance the practice and facilitate the systematic development of forensic psychology; encourage a high level of quality in professional practice; and encourage forensic practitioners to acknowledge and respect the rights of those they serve.” It provides guidelines on several issues encountered by practitioners of “forensic psychology” (e.g., multiple relationships, fees, informed consent, and confidentiality), which it defines as “professional practice by any psychologist working within any sub-discipline of psychology (e.g., clinical, developmental, social, cognitive) when applying the scientific, technical, or specialized knowledge of psychology to the law to assist in addressing legal, contractual, and administrative matters.”

Question 42

Tarasoff Decision

Answer 42

The original Tarasoff decision established a “duty to warn” an intended victim of a therapy client; however, in a rehearing of the case, this was changed to a “duty to protect” an intended victim by warning him/her, notifying the police, or taking other steps. In most jurisdictions, the duty to warn/protect applies only when a client poses a clear and imminent danger to an identifiable victim or victims (although, in some jurisdictions, the duty has been expanded to include an identifiable “class of victims”).

Question 43

Test Data and Materials

Answer 43

Standard 9.04 defines test data as “raw and scaled scores, client/patient responses to test questions or stimuli, and psychologists’ notes and recordings concerning client/patient statements and behavior during an examination.” It also states that “pursuant to a client/patient release, psychologists provide test data to the client/patient or other persons identified in the release.” Standard 9.11 requires psychologists to “make reasonable efforts” to protect the integrity and security of test materials, which include “manuals, instruments, protocols, and test questions or stimuli.”

Question 44

Test Scoring And Interpretation Services

Answer 44

Standard 9.09 states: “(a) Psychologists who offer assessment or scoring services to other professionals accurately describe the purpose, norms, validity, reliability, and applications of the procedures and any special qualifications applicable to their use … [and] (c) Psychologists retain responsibility for the appropriate application, interpretation, and use of assessment instruments, whether they score and interpret such tests themselves or use automated or other services.”

Question 45

Vicarious Liability

Answer 45

Under certain circumstances, supervisors and employers may be legally responsible for the actions of their supervisees and employees. This is referred to as vicarious liability (respondeat superior).